Abstract Hispanic/Latinos will comprise more than 30% of the U.S. population by mid-century, and Mexican Americans account for the largest share of this growing segment of society. This proposal aims to use door-to-door surveillance in Nueces County, Texas, a non-immigrant, bi-ethnic community, to determine the prevalence and trajectory over time of cognitive impairment and dementia in Mexican Americans and non-Hispanic whites. We will elucidate the mechanisms that explain the hypothesized ethnic disparity in Alzheimer?s disease and Alzheimer-related dementias by evaluating the roles of vascular disease risk factors, educational attainment and socio-economic status among others. This research will also delve deeply into the differences in informal caregiving for Mexican American and non-Hispanic whites with cognitive impairment and dementia. Caregiver burden and mental and physical health of caregivers will be examined toward efforts to develop interventions that build resilience in caregivers. A novel ability of this population-based study is to examine community resources for both patients and caregivers, and how these provisions differ by ethnicity. Using a rigorous mixed methods approach we will identify the gap between available resources and needs for those with cognitive impairment and dementia. In this way we will be well positioned to propose ethnic-specific testable interventions that promote mental and physical health for those with cognitive impairment and dementia, as well as for those family members who provide the care. This research will therefore lead to improved well- being, autonomy and outcomes among those with cognitive impairment and dementia and their caregivers. The investigative team members have conducted research in this community for 20 years and are experts in Mexican American culture and health, cognitive impairment and dementia, epidemiologic methods, community needs assessment and health behavior research. As the Mexican American population continues its tremendous growth and aging it is vitally important to better understand the prevalence and outcomes of cognitive impairment and dementia in this population, and to rapidly develop interventions that address the burden of these common conditions in Mexican American adults, families, and communities.